A nutritional approach to dealing with Arthritis, may well give relief
to many sufferers of these debilitating conditions and this review will
discuss several of the well researched natural agents that may be
incorporated into a regime to help relieve the pain and inflammation
associated with degenerative joint disease, concentrating mainly on
osteoarthritis.

Boswellia (Boswellia serrata) has traditionally been used for a myriad of
disorders and today its major use is as an anti-inflammatory agent for
musculoskeletal problems.
Research has compared Boswellia with non-steroidal, anti-inflammatory
agents and it has been shown to be as effective with fewer side effects.
Non-steroidals such as ibuprofen can cause gastrointestinal side effects,
but Boswellia has no such activity.
The mechanism of action of Boswellia is still not fully understood, but
it is thought to be due to the Boswellic acid and its derivatives exerting
anti-inflammatory effects by reducing the inflammatory and immune response,
which leads to faster healing.3
Due to its inhibitory effects on the immune system, Boswellia is not
recommended for pregnant women or those with compromised immune functions.
Boswellic acid has shown to be a potent 5-lipoxygenase inhibitor.
(5-lipoxygenase is an enzyme, which stimulates eicosanoids to be produced
from fatty acids thus causing an increase in pain and inflammation.).

Curcumin (Curcuma longa) is the yellow pigment and active
component found in the spice turmeric, obtained from the powdered rhizomes
of the plant Curcuma longa. It is commonly used as a colouring agent in
foods. Curcumin appears to have a variety of actions that make it a potent
anti-inflammatory agent, including its ability to scavenge nitric oxide, act
as an antioxidant, inhibit synthesis of interleukin-1 and tumour necrosis
factor, and inhibit lipoxygenase and cyclo-oxygenase.5,6,7
Curcumin has also been shown to induce the production of glutathione,
suggesting it may be beneficial in conditions of impaired detoxification.8
Curcumin has been used clinically as an anti-inflammatory for
conditions such as post-operative inflammation, rheumatoid arthritis and
osteoarthritis.

White Willow (Salix alba) contains bitter phenolic and
flavonoid glycosides. The most active is salicin, which is converted in the
liver to acetyl-salicylic acid, an effective anti-inflammatory agent, but
which does not have the gastrointestinal toxicity associated with aspirin
(salicylic acid).
The salicylates inhibit the activity of the cyclo-oxygenase enzyme and
thus inhibit the production of prostaglandins, which can lead to a reduction
in pain and inflammation.

Ginger (Zingiber officinale) is another well-known
culinary herb which has been studied and contains gingerol, an active
phenylketone which has a structure similar to aspirin, which may explain the
similar effect these two compounds have on prostaglandins.13,14,15
A small clinical study in Denmark involving seven patients, who took an
average of 5g of fresh ginger daily for three months, reported less pain,
better mobility and a reduction in swelling and stiffness.MSM (Methyl Sulphonyl Methane) is an organic salt found
in plants and animals and manufactured in the body from sulphur-containing
amino acids. It is a primary sulphur donor which has antioxidant properties.
Studies have demonstrated the efficiency in reducing the signs of arthritis
in animals. It may also inhibit autoimmune reactions.

Glucosamine sulphate is one of the most well-known and
well-researched formulas for improving joint health. Glucosamine sulphate
(GS) provides the joints with the building blocks they require to repair the
damage caused by osteoarthritis. GS is a simple molecule composed of
glucose, an amine (nitrogen and two molecules of hydrogen) and sulphur. GS
stimulates the formation of chondrocytes (cartilage cells), which helps to
build up the cartilage matrix by converting glucosamine into proteoglycans.
As well as this, GS promotes the incorporation of sulphur into cartilage.
Therefore GS not only stimulates the manufacture of substances necessary for
proper joint function, it is also responsible for stimulating joint repair.
It appears that as some people age they lose the ability to manufacture
significant amounts of glucosamine, resulting in cartilage that can no
longer carry out its role efficiently. This could be a major factor leading
to osteoporosis.
Because GS is a relatively small molecule it is easily absorbed and
travels primarily to joint tissue where it is incorporated into cartilage.
The sulphur component of GS appears to play a critical role in the
beneficial effects noted from this compound. Sulphur is an essential
nutrient for joint tissue where it functions in the stabilization of the
connective tissue matrix of cartilage, tendons and ligaments. As far back as
the 1930s, researchers demonstrated that individuals with arthritis are
commonly deficient in this essential nutrient.21 Restoring sulphur levels
brought about significant benefit to these patients.22 Other essential
nutrients required for joint function include vitamin C for collagen
formation and copper as a co-enzyme for lysyl-oxidase, essential for the
conversion of collagen and elasticin.

Summary

It can be seen that natural substances are important adjunctive agents
in the treatment of inflammatory musculoskeletal conditions. By employing a
natural approach, pain and inflammation may well be decreased, joint
movement and flexibility improved and unpleasant side effects associated
with drugs avoided.